Bisphosphonate associated osteomyelitis of the jaw in patients with bony exposure: prevention, a new way of thinking

Objective There is strong evidence of a link between the use of systemic bisphosphonates (BPs) and osteonecrosis of the jaw, especially in cancer patients. Among risk factors for BRONJ, tooth extraction and immune suppressive drugs seem to have significant role on bone healing. Therefore, the importance of these parameters in development of BRONJ was reviewed in this retrospective study in two maxillofacial surgery units. Material and Methods From 2007 to 2012, 46 patients on bisphosphonate who had developed oral bony lesions participated in this study. The pharmacological exposure, comorbidities, maxillofacial findings, types of treatment and outcome data were collected from clinical and radiological records. Results The most frequently used BP was alendronate (67%). Tooth extraction was reported in 61% of patients with BRONJ. Systemic corticosteroids were prescribed in 35 cases (76%) as an adjuvant for BP. Patients on corticosteroids had a lower probability of bony lesion healing (

Primary intraosseous carcinoma arising in a dentigerous cyst: A case report

Dentigerous cysts are among the most common cysts of the jaw. They are attached to the crown of an unerupted tooth, most frequently third molars and maxillary canines. They are often asymptomatic and may therefore be diagnosed late. We report a case of a primary intraosseous carcinoma arising from the wall of a dentigerous cyst and describe the expression of typical genes associated with tumour growth and prognosis. The tumour expressed cytokeratins (CK) 5/6, 8, 14 and 19, but not CK7. Ki-67 and P53 were upregulated in dysplastic epithelium and tumour tissue. Although rare, the possibility for tumour development in the wall of a common cyst should be considered. The case emphasizes the importance of histopathological examination of surgical specimens, even if the clinical diagnosis seems obvious

Hormone spiral in treatment of progesterone-induced stomatitis

Hormonal changes in the menstrual cycle may cause autoimmune progesterone-induced stomatitis. This case illustrates that insertion of a hormone spiral can be a treatment option to reduce mucosal lesions and symptoms.publishedVersio

Kraniofaciale og orale senskader etter behandling av barnekreft.

Source at https://www.tannlegetidende.no/journal/2021/5/m-582/Kraniofaciale_og_orale_senskader_etter_behandling_av_barnekreft.Årlig blir ca. 190 norske barn rammet av kreft. Aldersgruppen 0–6 år har den høyeste forekomsten. Leukemier og svulster i sentralnervesystemet utgjør hver ca. 30 %, lymfomer rundt 12 %, mens de resterende består av mer sjeldne svulster med en prevalens fra 1–7 %. Både diagnostikk og behandling følger internasjonale protokoller og er sentralisert til følgende fire sentre i Norge; Oslo universitetssykehus Rikshospitalet, Haukeland universitetssjukehus, St. Olavs hospital samt Universitetssykehuset Nord-Norge. Behandlingen er ofte multimodal og består av kombinasjoner av cytostatika, kirurgi og strålebehandling eventuelt i kombinasjon med benmargstransplantasjon. 5-årsoverlevelse i 2019 var 86 %, men to av tre barn som overlever får senskader som følge av sykdommen og/eller behandlingen. Senskadene omfatter risiko for sekundærkreft, kronisk trøtthet, endret psykososial funksjon, hjerte-, sirkulasjons- eller lungesykdom, kognitiv svekkelse, infertilitet og endokrin dysfunksjon. Orale senskader kan bestå av kraniofaciale vekstforstyrrelser, tannutviklingsforstyrrelser, som avvik i mineralisering, krone- og/eller rotutvikling eller agenesier, malokklusjon, redusert spyttsekresjon, økt kariesprevalens, trismus og slimhinneproblemer. For å diagnostisere og behandle senskader følger de barneonkologiske avdelingene opp kreftoverleverne i fem år, mens Den offentlige tannhelsetjenesten ikke har tilsvarende system for oppfølging av orale senskader etter barnekreft. Kunnskap om og behandling av orale senskader etter barnekreft er derfor ofte mangelfull og kan være en oversett årsak til redusert livskvalitet

Osteomyeliu i underkjeven

Hevelser og smerter i kjeven er ofte assosiert med infeksiøs odontogen sykdom og vil typisk diagnostiseres og behandles hos tannlege. I noen tilfeller kan imidlertid ikke tanninfeksjoner påvises. Vi presenterer fire sykehistorier hos barn som illustrerer ulike utfordringer ved en velkjent, men relativt dårlig definert diagnose i medisinen

Misinterpretation of histopathological results as an important risk factor for unneeded surgery – case report of a "near miss" event in a pregnant woman

The oral cavity may exhibit a vast number of pathologic conditions, often dealt with by different medical disciplines. Combined with a substantial variation in clinical appearance, an accurate diagnosis may provide difficult to establish in selected cases. Histopathological investigations are therefore mandatory for correct diagnosis and adequate treatment. We describe a common, truly benign condition in the oral cavity, which due to histopathological misinterpretation was planned for major surgery and subsequent chemotherapy. This was avoided by spontaneous regression of the lesion. The case illustrates that uncritical trust in laboratory diagnostic tests may lead to severe mistreatment

Misinterpretation of histopathological results as an important risk factor for unneeded surgery – case report of a "near miss" event in a pregnant woman

Abstract The oral cavity may exhibit a vast number of pathologic conditions, often dealt with by different medical disciplines. Combined with a substantial variation in clinical appearance, an accurate diagnosis may provide difficult to establish in selected cases. Histopathological investigations are therefore mandatory for correct diagnosis and adequate treatment. We describe a common, truly benign condition in the oral cavity, which due to histopathological misinterpretation was planned for major surgery and subsequent chemotherapy. This was avoided by spontaneous regression of the lesion. The case illustrates that uncritical trust in laboratory diagnostic tests may lead to severe mistreatment.</p

Marine restråstoff til gjødsel?

This paper describes results obtained in several projects at NORSØK to study the effect of residuals of captured fish (cod, saithe etc.) and seaweed residuals for fertilisation of crop plants. Whereas fish residues have a very rapid growth efffect, seaweed residues have demonstrated an interesting residual effect over several years in local field trials

Multiple brain abscesses and ventriculitis secondary to chronic periodontitis

Chronic marginal periodontitis is a common oral disease, but can in rare cases cause severe intracranial infection. This case illustrates that poor dental status can be life threatening, in particular for immunocompromised patients